When 1+1=3 – Part 1

If there’s one truism that 14 years in the Vision Therapy room have taught me, it’s that assumptions are dangerous – maybe even disastrous. It can be difficult to avoid assumptions though, we all perceive the world through our own filter and at times those filters can be jaded by our past experiences and expectations. My toughest days in VT are those where my personal and outside world is clouding my filter; while my greatest days in therapy – that is the days I feel I am really “on” – are the days where my mechanism for assumptions is checked at the door or even unplugged all together.

As patient profiles go, Caroline was pretty straight forward as a second grader who is falling behind ever so slightly in reading. Her exam findings were decent but revealed a few small areas of concern, and she enrolled in Vision Therapy. The initial estimation for her program was a duration of 4 months. Since there were no academic concerns beyond reading, the bulk of our time with Caroline in the VT room was to be focused on improving her reading skills. Along the way, her mom shared an interesting, yet seemingly random, observation about Caroline’s math skills during one of our sessions:

“It seems like she forgets how to count” mom shared.

The context of the comment was within a larger conversation regarding a recent parent/teacher conference. The report from Caroline’s teacher was all positive, including improved reading skills since beginning Vision Therapy. Mom’s comment was recorded in Caroline’s chart simply as an “area to explore”. End of conversation. My assumption at the time was “Yeah, right. She’s in second grade with a stellar report card – she knows how to count”. I assumed mom was perhaps being a little over zealous.

Bad move on my part.

The following week though, I performed my due diligence with Caroline and pulled out 10 one-inch cubes to review 1:1 correspondence. As customary, we started with a group of five blocks and counted them for each other. First it’s my turn. 1…2…3…4…5. Good, now you count them for me. 1…2…3…4…5. Good. We reviewed who has more, who has less, how spatial orientation of a set number of blocks doesn’t change the quantity, and even talked about how grouping them differently can change the value. She flew through it. Like I thought, she seems solid in this area.

I was feeling pretty good about my assumption that everything was OK with Caroline’s counting and math, that is until my proverbial glass house was shattered by my next question. With the blocks hidden, I asked Caroline “if you had one block and I had one block, and we decided to put them together in a pile, how many blocks would be in our pile?”